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医保商保融合提速,“多驾马车”破局支付困境
Bei Jing Shang Bao· 2025-07-10 13:55
Core Insights - The launch of the first national "Medical Insurance + Commercial Insurance" clearing and settlement center marks a significant shift in the payment landscape, allowing seamless integration between medical insurance and commercial insurance, reducing the burden on patients [1][2] - The integration of medical insurance and commercial insurance is entering a fast track, with various companies leveraging their strengths to innovate and enhance payment efficiency [2][4] Group 1: Policy and Technological Developments - The National Medical Insurance Administration has expressed a commitment to exploring the collaborative development of basic medical insurance and commercial medical insurance, with the recent establishment of the clearing center being a pilot project aimed at facilitating this integration [2] - Companies like Megxin Health have pioneered concepts such as "commercial insurance identity medical treatment," introducing platforms that allow for direct payment at public hospitals, enhancing user experience by enabling "pay after treatment" [2][4] Group 2: Innovations by Key Players - Alipay has introduced the "Commercial Insurance Code," which utilizes national medical insurance data to streamline the settlement process, significantly reducing the financial burden on patients [3][4] - Ping An Good Doctor has launched "Ping An Medical Payment," a product that leverages medical insurance data to achieve seamless and rapid claims processing, creating a closed-loop payment and service model [3][4] Group 3: Industry Transformation and Future Outlook - The integration of medical insurance and commercial insurance is redefining the concept of "innovative payment," enhancing payment efficiency and improving the quality of life for patients [5][6] - The shift from simple complementarity to a data and service ecosystem is driving competition in the health insurance sector, moving away from price wars to service-oriented competition [6][8] - The anticipated full implementation of the "Medical Insurance + Commercial Insurance" one-stop settlement model is projected to unlock a trillion-level health insurance market, fostering a new ecosystem of medical, insurance, and technology integration [7][8]